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Administration wants more restraint over antimicrobial use

​By Greg Cima

Posted Oct. 29, 2014

Federal agriculture authorities will reduce certain uses of antimicrobials in agriculture as part of a strategy to reduce risks from antimicrobial-resistant bacteria, according to an executive order published in September.

“The Federal Government will work domestically and internationally to detect, prevent, and control illness and death related to antibiotic-resistant infections by implementing measures that reduce the emergence and spread of antibiotic-resistant bacteria and help ensure the continued availability of effective therapeutics for the treatment of bacterial infections,” it states.

The order also will require antimicrobial stewardship in health care industries, although a Food and Drug Administration spokeswoman said that objective is focused on stewardship efforts in human health care. By the end of 2016, the Department of Health and Human Services will have to propose regulations or other actions that would require “robust antibiotic stewardship programs” in hospitals and other inpatient health care facilities and encourage adoption of stewardship programs by outpatient facilities, according to the order.

The Food and Drug Administration, which is part of the HHS, and the Department of Agriculture are ordered to collaborate and take actions to prohibit use of drugs from antimicrobial classes important for human medicine toward improving growth of animals raised for food. The FDA already expects to reduce access to and use of those drugs by the end of 2016; 26 pharmaceutical companies have agreed to let the agency by then remove approvals that allow administration of the drugs in feed or water to promote livestock growth and that allow over-the-counter sales of those drugs.

According to the executive order, the FDA, USDA, and Environmental Protection Agency will need to coordinate with each other in common program areas, such as those involving surveillance over antimicrobial use and resistance in food animals, interspecies disease transmissibility, and research findings.

A White House announcement about the order states that bacteria resistant to antimicrobials threaten public health, national security, and the economy. Drug-resistant infections are associated with 23,000 deaths and 2 million illnesses yearly as well as $20 billion in health care costs and $35 billion in lost productivity.

In addition to requiring action from existing departments and agencies, the order creates a 30-member federal advisory council on antimicrobial resistance and establishes a multiagency task force to develop a national plan for implementing a strategy to detect, prevent, and combat resistant bacteria.

And federal authorities will sponsor a $20 million prize for development of a rapid diagnostic test that health care providers could use to identify bacterial infections highly resistant to antimicrobials.

The administration published a pair of reports along with the executive order. One of the reports describes the national strategy to identify, fight, and prevent the spread of antimicrobial-resistant bacteria, and the other describes recommendations by the President’s Council of Advisors on Science and Technology on federal government actions that could help the nation fight antimicrobial-resistant bacteria.